Instructions For Rct-123 - Gross Premiums Tax - Surplus Lines Agents - Pennsylvania Department Of Revenue Page 2

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minimum of $500, regardless of the
Electronic Payment
electronic method to make a payment
determined
tax
liability,
plus
an
Enter “Y” in the block on Page 1 if the
with an extension request should not
taxpayer has made any electronic pay-
additional 1 percent of any determined
submit the extension coupon. Do not
ments using e-TIDES.
tax liability over $25,000.
use the extension coupon to remit other
unpaid liabilities within the account.
Final Report
Address Change
Enter “Y” in the block on Page 1 if
Enter “Y” in the block on Page 1 if the
Payment and Mailing Information
this report will be the final report
address of the corporation has changed
All payments of $1,000 or more must be
filed with the department. Indicate
from prior tax periods. The current
made electronically or by certified or
the effective date of the event as
mailing address should be reflected on
cashier’s check remitted in person or by
MMDDYYYY.
the report.
express mail courier. Failure to make a
payment by an approved method will
Include information from the Penn-
Correspondence to Preparer
sylvania Insurance Department
result in the imposition of a 3 percent
Enter “Y” in the block on Page 1 if all
verifying the taxpayer’s insurance
penalty of the tax due, up to $500. For
correspondence (notices and requests
license expired, was cancelled or
more information on electronic payment
for additional information) is to be sent
not renewed.
options, visit
to the preparer’s address. If “Y” is
Payments under $1,000 may be remit-
entered, the address recorded on Page
Include a copy of the regulatory
ted by mail, made payable to the PA
2 will be used.
authority’s approval of the merger,
Department of Revenue.
dissolution, plan of reorganization
Amended Report
and/or articles of merger.
Mail payments, extension requests and
Enter “Y” in the block if you are filing an
Tax Report, RCT-123 to the following
amended report to add, delete or adjust
Provide the Revenue ID and FEIN of
the surviving entity, if applicable.
address:
information. Provide documentation to
support all changes being made. An
Corporate Officer Information
PA DEPARTMENT OF REVENUE
amended report should only be filed if
A corporate officer must sign and date
327 WALNUT ST FL 3
an original report was filed previously
the tax report. The signature must be
PO BOX 280407
for the same period.
original; photocopies or faxes will not be
HARRISBURG PA 17128-2005
accepted. Print the first and last name,
An amended report must be filed within
Current Period Overpayment
title, Social Security number, telephone
three years of the filed date of the
If an overpayment exists on Page 1 of
number and email address of the corpo-
original report. The department may
the RCT-123, the taxpayer must instruct
rate officer.
adjust the tax originally reported based
the department to refund or transfer
on information from the amended
Preparer’s Information
overpayment as indicated below.
report. The taxpayer must consent to
Paid preparers must sign and date the
extend the assessment period. If the
Refund: Identify the amount to refund
tax report. If the preparer works for a
amended report is timely filed and the
firm, provide the name, FEIN and
from the current tax period overpay-
taxpayer consented to extend the
address of the firm along with the
ment. Prior to any refund, the depart-
assessment period, the time period in
name, telephone number, email address
ment will offset current period liabilities
which to assess tax will be the greater
and PTIN/SSN of the individual prepar-
and other unpaid liabilities within the
of three years from the filed date of the
ing the report. If the preparer is an
account.
individual without any association to a
original report or one year from the filed
Transfer: Identify the amount to
firm, provide the name, address,
date of the amended report.
transfer from the current tax period
telephone number, email address and
Regardless of the tax year being
overpayment to the next tax period.
PTIN/SSN of the individual preparing
amended, taxpayers must use the most
Prior to any transfer, the department
the report.
current non-year-specific tax form,
will offset current period liabilities and
Extension Request Due Date
completing all sections of the report.
other unpaid liabilities within the
To request a due date extension of up
This includes those sections originally
account.
to 60 days to file the annual report, you
filed and those sections being amended.
must file an extension request, REV-
NOTE: If no option is selected,
All tax liabilities should be recorded on
426, by the original report due date.
the department will automatically
Page 1. Taxpayers must check the
However, an extension of time to file
transfer any overpayment to the next
Amended Report check box on Page 1
does not extend the deadline for pay-
tax year after offsetting current period
and include Schedule AR, REV-1175,
ment of tax, and an extension request
liabilities and other unpaid liabilities
with the report.
must be accompanied by payment of
within the account.
First Report
taxes owed for the taxable year for
Enter “Y” in the block on Page 1 if this
A tax period overpayment summary will
which the extension is requested. Mail
is the taxpayer’s first PA gross
be mailed to the taxpayer confirming
the extension coupon separately from
premiums tax filing.
all other forms. A taxpayer using an
the disposition of the credit.
RCT-123
2

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